Balloon dacryocystoplasty: indications and contraindications.

Berkefeld, Joachim; Kirchner, Johannes; Muller, HK; Fries, U.; Kollath, J

doi:10.1148/radiology.205.3.9393536

Cited by 54 publications

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“…In our institution, first balloon dacryocystoplasties were performed in an unselected patient population with the whole spectrum of obstructive lesions. A clinical and dacryocystographic study with short-term follow-up up to 6 months suggested that clinical failures and early recurrences were associated with the presence of (1) complete obstructions of the whole lengths of the nasolacrimal duct (NLD) without dacryocystographically visible stump, (2) multiple or diffuse stenoses including canalicular narrowings, (3) active dacryocystitis or dacryocystolithiasis or (4) posttraumatic obstructions [6]. …”

Section: Introductionmentioning

confidence: 99%

Clinical Effectiveness of Balloon Dacryocystoplasty in Circumscribed Obstructions of the Nasolacrimal Duct

Lüchtenberg

Bartel²,

Bink³

et al. 2007

Ophthalmologica

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Purpose: Balloon dacryocystoplasty (DCP) is known to have limited clinical success rates. In a previous publication, we tried to define subgroups that could benefit from interventional treatment of tear duct stenoses. The purpose of this study was to evaluate the clinical effectiveness of DCP performed with limited indication confined to patients with circumscribed stenosis or distal occlusion of the nasolacrimal duct (NLD). Patients and Methods: Twenty-nine patients with severe epiphora due to dacryocystographically proven postsaccal obstruction of the lacrimal draining system were treated by means of DCP and were available for a telephone interview after a median follow-up period of 40 months (5–75 months). A standardized questionnaire covered the individual history of epiphora before and after interventional treatment. All patients had circumscribed stenoses of the lower lacrimal sac or the NLD or presented with short-distance occlusions of the distal NLD. Patients with canalicular, high saccal or diffuse lesions as well as cases with active dacryocystitis, suspicion of dacryocystolithiasis or posttraumatic stenosis were excluded from DCP. Failures or recurrences with no major improvement compared with the initial status were taken as a study endpoint. Results: We dilated 21 partial and 8 complete obstructions and post-DCP control dacryocystograms showed a widening of the ductal lumen or improvement of flow. In 25 out of 29 patients, regression of clinical symptoms occurred during the first week after treatment, 4 cases remained unchanged. Ten out of 25 patients with initial improvement reported recurrence of severe epiphora after a median period of 5 months. Five patients of all treated patients (n = 29) received additional operative dacryocystorhinostomy (DCR) after failure of DCP or due to severe recurrences. One patient received DCR during the 1st week after DCP (n = 1). Four out of 25 patients with initial improvement underwent DCR. Overall, 15 of the 29 treated patients had durable improvement of epiphora by DCP alone. Conclusion: Even patients with circumscribed obstructions of the NLD and exclusion of factors potentially associated with poor outcome of tear duct stenosis after DCP balloon dilatation showed a limited clinical success and high recurrence rate. The main argument to continue DCP as first or second line treatment in selected patients with duct obstructions is its lack of invasiveness. Even patients with increased risk of general anesthesia can be treated and approximately half of the operations may be avoided.

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Section: Introductionmentioning

confidence: 99%

Clinical Effectiveness of Balloon Dacryocystoplasty in Circumscribed Obstructions of the Nasolacrimal Duct

Lüchtenberg

Bartel²,

Bink³

et al. 2007

Ophthalmologica

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“…[14][15][16][17][18] However, few studies have explored its effectiveness in lacrimal canalicular obstruction, because balloon dilation of the canaliculus has been considered risky owing to the possibility of damage to the canaliculus. 19,20 There are, however, some reports that balloon catheter dilation of the common canaliculus is safe and effective. 21,22 We present a new and simple surgical procedure using balloon dilation of the canaliculus and common canaliculus.…”

mentioning

confidence: 99%

Ballooning canaliculoplasty after lacrimal trephination in monocanalicular and common canalicular obstruction

2008

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“…Die ursprünglich bei der Dakryozystoplastie zur Verfügung stehenden Ballonkatheter konnten aufgrund des großen Schaftdurchmessers nicht über die filiformen Tränenpünktchen in den Tränenapparat eingeführt werden, so dass anfangs eine transnasale Vorgehensweise erforderlich war [5,15,19,31,51,53]. Die mit der retrograden transnasalen Vorgehensweise verAbbildungen 3a bis 3d.…”

Section: Interventionelle Radiologische Therapieunclassified

“…Die Konkrementbildung ist in der Regel entzündlich bedingt [20,65,66]. Dakryolithen stellen sich in der Dakryozystographie als prästenotisch kontrastmittelumspülte Füllungsdefekte dar, die je nach Kontrastmittelinjektionsdruck und Position des Patienten frei im Tränenapparat flottieren können [5,29]. Differentialdiagnostisch müssen versehentlich mit der Kontrastmittelapplikation in den Tränenapparat injizierte Luftblasen ausgeschlossen werden.…”

Section: Therapie Der Dakryolithiasisunclassified

Interventionelle radiologische Therapie der Tr�nenwege

Lachmund

Wilhelm

Remonda

et al. 2005

Klinische Neuroradiologie

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ZusammenfassungDer Augenpatient, in dessen Diagnostik und Therapie der Radiologe involviert ist, leidet gewöhnlich unter ständigem Tränenträufeln, der Epiphora. Die Epiphora ist ein häufiges Krankheitsbild und wird bei ca. 3% aller Patienten einer ophthalmologischen Praxis diagnostiziert. Epiphora ist entweder die Folge einer Überproduktion oder einer Abflussstörung von Tränenflüssigkeit infolge einer Obstruktion im Tränengangsystem. Epiphora wird am häufigsten durch Stenosen oder Verschlüsse des Tränengangsystems verursacht. Die Obstruktion ist meist im Bereich von Saccus und Ductus nasolacrimalis lokalisiert. Während in der Vergangenheit die Therapie ausschließlich operativ mittels Dakryozystorhinostomie erfolgte, wurden mittlerweile interventionelle radiologische Techniken entwickelt, die in bestimmten Fällen eine Alternative darstellen. Um die für den Patienten geeignetste Therapieform zu finden, müssen die genaue Ursache und Lokalisation der Epiphora abgeklärt werden. Hierbei stellt die in digitaler Subtraktionstechnik durchgeführte Dakryozystographie das bildgebende Standardverfahren dar. Im therapeutischen Bereich sind die interventionellen radiologischen Techniken der Dakryozystoplastie gegenüber den operativen Verfahren minimal invasiv, können ambulant und in Lokalanästhesie durchgeführt werden und erhalten die normale Anatomie des Tränenapparats. Zusätzlich kann eine störende Narbenbildung vermieden werden. Bei vergleichbaren technischen und klinischen Erfolgsraten stellt insbesondere die Ballondilatation bei Stenosen eine therapeutische Alternative zur Operation dar. Auch die Stentimplantation ist bereits jetzt eine wertvolle Therapieoption für die Behandlung von Tränenwegsverschlüssen. Die Stentimplantation ist besonders bei den Patienten indiziert, die einer operativen Therapie nicht zugänglich sind oder diese ablehnen. Schlüsselwörter: Tränenapparat · Epiphora · Dakryozystoplastie · Tränensack · Tränenwege · Ballondilatation · Stent-Implantation Klin Neuroradiol 2005;15:50-61 AbstractThe lacrimal system has become of interest to the radiologist, as radiologic interventions, requiring adequate diagnostic work-up, have been described. The eye doctor's patients, in whose diagnosis and treatment the radiologist may be involved, usually complain of constant tearing, epiphora. Epiphora is a common ophthalmologic problem, comprising 3% of clinical visits. It results from either overproduction or impaired drainage of lacrimal fluid, because of stenosis/obstructions of tear ducts. Severity of epiphora is graded clinically according to the scale of Munk et al., that takes the number of daily dabbings into account. Epiphora is mostly caused by stenosis or complete obstruction of the nasolacrimal duct system. The most common site of obstruction is the junction of the saccus and nasolacrimal duct. While in the past, treatment of this condition was surgical (e.g., by dacryocystorhinostomy), interventional procedures have been developed and have become well established for treatment in selected cases. To identify ...

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Balloon dacryocystoplasty: indications and contraindications.

Cited by 54 publications

References 0 publications

Clinical Effectiveness of Balloon Dacryocystoplasty in Circumscribed Obstructions of the Nasolacrimal Duct

Clinical Effectiveness of Balloon Dacryocystoplasty in Circumscribed Obstructions of the Nasolacrimal Duct

Ballooning canaliculoplasty after lacrimal trephination in monocanalicular and common canalicular obstruction

Interventionelle radiologische Therapie der Tr�nenwege

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